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Montana rates for HCPCS 21089

Unlisted maxillofacial prosthetic procedure

Facilitymedian $631 · 10th–90th $631–$6920%50%90th$631Professionalmedian $85 · 10th–90th $79–$6920%20%40%10th90th$85$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $630.96 / $691.83
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $630.96 / $691.83
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $79.43 / $85.11